Prognostic value of EZH2 expression for immunotherapy-based schemes in advanced soft-tissue sarcoma: A translational research from Spanish Group of Research on Sarcoma (GEIS).

Authors

null

David Silva Moura

Group of Advanced Therapies and Biomarkers in Sarcomas, Health Research Institute-Fundación Jiménez Díaz University Hospital, Madrid, Spain

David Silva Moura , Jorge Zamora , Nadia Hindi , Maria Lopez-Alvarez , Serena Lacerenza , Giovanni Grignani , Javier Martinez-Trufero , Andres Redondo , Claudia Maria Valverde Morales , Silvia Stacchiotti , Antonio Lopez-Pousa , Antonio Gutierrez , Jose A. Lopez-Martin , Javier Martin Broto

Organizations

Group of Advanced Therapies and Biomarkers in Sarcomas, Health Research Institute-Fundación Jiménez Díaz University Hospital, Madrid, Spain, Health Research Institute-Fundación Jiménez Díaz University Hospital, Autonomous University of Madrid (IIS-FJD, UAM), Madrid, Spain, Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville, Ibis/Hospital Universitario Virgen Del Rocío/Csic/Universidad De Sevilla, Seville, Spain, Division of Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo (TO), Italy, Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain, Hospital Universitario La Pa–IdiPAZ, Madrid, Spain, Vall d´Hebron University Hospital, Barcelona, Spain, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, Hospital Sant Pau, Barcelona, Spain, Hospital Universitario Son Espases, Palma De Mallorca, Spain, Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain

Research Funding

Other
Pharmaceutical/Biotech Company

Background: Immunotherapy-based treatments had shown to be active in several solid tumors, including in selected subtypes of sarcomas. IMMUNOSARC (NCT03277924) is a phase Ib/II trial [from Spanish (GEIS) and Italian (ISG) sarcoma groups], that tested the combination of nivolumab (anti-PD-1 inhibitor) plus sunitinib (anti-angiogenic agent) in advanced sarcomas. Among the 65 soft-tissue sarcoma (STS) patients (pts) enrolled, 48% were free of progression at 6 months, meeting the trial’s primary endpoint. EZH2 is the catalytic subunit of the Polycomb Repressive Complex 2 and it has been described to play an important role in the transcriptional repression of genes involved in T-cell migration and T-cell-mediated anti-tumor activity. The aim of this study was to explore the value of EZH2 gene expression as potential prognostic biomarker of the activity of immunotherapy-based schemes. Methods: The expression of EZH2 was evaluated in 64 paraffin tumor blocks, by direct transcriptomics, using HTG EdgeSeq Oncology Biomarkers Panel (HTG Molecular Diagnostics, Inc.; Tucson, AZ, USA). Data was normalized with DESeq2 and the cut-off of EZH2 expression was calculated with MAXSTAT R package. Gene expression was correlated with progression-free survival (PFS) by RECIST, overall survival (OS) and clinical benefit (patients with response or stable disease vs patients with progressive disease as best response). Results: Among the 64 pts analyzed, 52 (81%) showed overexpression of EZH2, considering a cut-off of 570.15 read counts. Undifferentiated pleomorphic sarcoma (UPS) and epithelioid sarcoma were the subtypes with higher expression of EZH2 with a median of read counts of 1888.04 (n = 10) and 1261.79 (n = 7), respectively. The lowest expressions were observed in extraskeletal myxoid chondrosarcoma (ECM) and alveolar soft-part sarcoma (ASPS) with a median of read counts of 461.42 (n = 4) and 680.84 (n = 7), respectively. Low expression of EZH2 was associated with better PFS (16.8 months vs. 3.9 months; p = 0.001) and better OS (NR vs. 20.0 months; p = 0.006). Moreover, low expression of EZH2 was also significantly associated with a clinical benefit of the patients treated with nivolumab plus sunitinib [relative risk (RR): 13; 95% CI: 3.0-56.9; p = < 0.001). Conclusions: Low expression of EZH2 was associated with better outcome in advanced STS patients treated with immunotherapy-based schemes. These results might support the rationale for the combination of EZH2 inhibitors with immune-modulating agents for future studies.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Sarcoma

Track

Sarcoma

Sub Track

Molecular Targets/Biomarkers/Tumor Biology

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 11549)

DOI

10.1200/JCO.2022.40.16_suppl.11549

Abstract #

11549

Poster Bd #

453

Abstract Disclosures